CERVICAL CANCER What every woman should know What is a cervix?

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1 CERVICAL CANCER What every woman should know What is a cervix? The cervix is the entrance to the womb from the vagina. It is the narrow, lower part of the uterus that is the passageway connecting the uterus to the vagina

2 What is your understanding of cervical cancer? Cancer that affects the entrance to the womb(cervix) Cervical cancer starts in the cells of the cervix. It is a slow-growing cancer that develops after the cells of the cervix start to change and become abnormal. Why talk about cervical Cancer? Cervical cancer is the most common cancer in Kenya and developing countries It is the leading cause of cancer related deaths in women in the country. Only cancer that is preventable through vaccination The cervix is easily accessible for screening, diagnosis and treatment HIV infection rate is higher among women in Kenya and a risk factor to cervical cancer What are the risk factors for cervical cancer?

3 2013 Source:Healthy Kartana, Gender: Any woman can get cervical cancer. Age: Most cases of cervical cancer occur in women younger than 50 years of age. Human papillomavirus (HPV): The most important risk factor for developing cervical cancer is infection with HPV. Most women who develop cervical cancer have had an HPV infection, but not all women with an HPV infection will develop cervical cancer. Smoking: Smoking has been linked to the development of cervical cancer as cigarettes contain many cancer-causing substances (carcinogens) that affect many parts of the body. Multiple pregnancies: Women who have given birth to several children have an increased risk of developing cervical cancer. Multiple sexual partners: Women with multiple sexual partners are at a higher risk of exposure to human papillomavirus (HPV), which is associated with cervical cancer. Becoming sexually active at a young age increases the risk of exposure to HPV Weakened immune system: A weakened immune system can decrease the body s ability to defend itself against

4 foreign cells, such as cancer cells or micro-organisms that cause infection. What is Human Papilloma Virus? A group of viruses that affect the skim and moist membrane lining of the body including the cervix, anus, mouth and throat HPV is contagious and is passed through skin to skin contact very easily passed through mucous membranes, body fluids and small beaaks in the skin. There are more than 100 types of HPV HPV infection can cause cervical cancer and other minor problems lik skin and genital warts. What are the signs and symptoms of cervical cancer? Early Signs and Symptoms Abnormal vaginal bleeding, spotting or blood-stained discharge between periods unusually long or heavy periods Bleeding after sexual intercourse or pain during sexual intercourse Bleeding after douching Bleeding or bloody discharge from the vagina after menopause Clear, watery discharge, increased amount of discharge or foul-smelling discharge

5 Late Signs and Symptoms Late signs and symptoms may occur as the cancer grows larger or spreads to other parts of the body, including other organs. They include; Pain in the pelvic area or lower back that may go down the leg(s) and swelling of the leg Change in bladder habits such as loss of bladder control or blood in the urine Change in bowel habits such as blood in the stool or constipation Anemia (low iron), which causes tiredness, lack of energy and shortness of breath Weight loss or shortness of breath How is cervical cancer diagnosed? Diagnostic tests for cervical cancer are usually done when: The signs and symptoms of cervical cancer are present The physician suspects cervical cancer after talking with a woman about her health and completing a physical examination A routine test (such as a Pap test) suggests abnormal changes in the cells of the cervix Many of the same tests used to initially diagnose cancer are also used to determine the stage (how far the cancer has progressed). Diagnostic and staging tests can vary but may include complete blood count, blood chemistry tests, biopsy, urinalysis, CT scans, etc. What are my treatment options? Physicians and specialists work together with the patient to decide on the best treatment plan. Treatment plans are designed to meet the unique needs of each person with cancer. Treatment decisions for cervical cancer are

6 based on: The size and stage of the cancer Personal factors, such as the woman's age and if she wants to have children in the future The woman's overall health A number of treatment options may be used collectively to treat cervical cancer. Treatment options for cervical cancer include: Surgery: Surgery to remove the cancer depends on the location and extent of cervical cancer and desired outcomes such as through a biopsy or hysterectomy. Radiation therapy: Radiation therapy uses high energy x-rays to kill cancer cells. Radiation may be used as the primary treatment, may be used in combination with other treatments to destroy or reduce cancer cells, or to relieve pain. The amount of radiation given during treatment, and when and how it is given, will be different for each person. Chemotherapy: Chemotherapy is a cancer treatment that utilizes anti-cancer drugs administered most commonly intravenously or by mouth. It is usually a systemic therapy that circulates throughout the body and destroys cancer cells. Drugs, doses and schedules vary from person to person. What next after treatment? There may be side-effects after treatment e.g. hair falling off Fear of recurrence is common and can be dealt with by joining a support group Make follow-up visits to the doctor to check for recurrence and your well-being Keep getting pap smear test regularly no matter the mode of treatment

7 Prevention tips Cervical Cancer Screening When should I begin screening? When cervical cancer is detected and treated early, the chances of successful treatment are better. Screening tests help find cervical cancer before any symptoms develop. The most reliable method of finding cervical cancer early is the Pap test. A Pap test is a procedure that removes a small sample of cells from the cervix so they can be examined for changes. Currently, screening for cervical cancer is recommended for sexually active women aged If a test shows a change or abnormality, follow-up tests or procedures may be required. What happens during cervical cancer screening? Pap smear

8 A sample of cells is taken from your cervix This is spread on a glass slide Sample analyzed in the lab for identification of abnormal cells VIA/VILI Stands for visual inspection with acetic acid/visual inspection with lugol s iodine Acetic acid and lugol s iodine are applied to your cervix and any colour change suggestive of abnormal cells noted Precancerous lesions found during screening can be treated before they progress to cancer HPV TEST A sample of cervical cells is taken to the lab. Advanced molecular technology is used to directly detect the HPV causing cervical cancer Cervical cancer vaccination HPV VACCINATION Two vaccines have been approved for use in protection against cervical cancer Vaccination consists of a 3 dose series administered within 6 months Suitable for females aged 9-26 years Boys between 9-15 years can also be vaccinated Gardasil

9 Cervarix The combination of screening and vaccination is very important because the two are complementary and the most effective way of helping to prevent cervical cancer. References 1. Harsh Mohan.2010.Textbook of pathology, 6th edition. New Delhi, India: Jaypee Brothers Medical publishers ltd. 2. D.C Dutta Textbook of gynaecology,5th edition. Kolkata, India: New central book agency ltd Pictures courtesy of THIS INFORMATION IS ONLY A GUIDE AND IS NOT MEANT TO REPLACE EXPERT OPINION Relay For Life Secretariat, Kenya Cancer Association, Kenyatta National Hospital Compound. P.O. BOX 293 KNH Nairobi Twitter: relay4life Facebook: relayforlifekenya

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